Dubord, David Roger

Dubord, David Roger is an sole proprietor health care provider with primary practice located at 6001 W North Ave , Wauwatosa WI 53213-1527. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Dubord, David Roger can be contacted via phone (414) 771-8110.

Contact Information

Primary practice address
6001 W North Ave Wauwatosa WI 53213-1527
Fax: (414) 771-7123
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2488-057 Wisconsin

Profile Details

NPI number 1639191513
LBN Legal business name Dubord, David Roger
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 23rd, 2006
Last updated Jul 15th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639191513 NPPES
Wisconsin MEDICAID 39768400

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